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ALTERNATING CONTRACTION ANISOCORIA: A Pupillary Syndrome of the Anterior Midbrain

ALTERNATING CONTRACTION ANISOCORIA: A Pupillary Syndrome of the Anterior Midbrain Abstract AMONG THE clinical cases examined in this laboratory a relatively large group showed a pupillary syndrome which I have named alternating contraction anisocoria. I have used the term contraction anisocoria in order to describe the appearance of inequality of the pupils under the influence of a pupilloconstrictor stimulus, such as light, while the term alternating is used because there is a variation as to which pupil becomes smaller. In alternating contraction anisocoria the pupil of the stimulated eye always contracts more extensively than does the consensually reacting pupil of the opposite side. Many neurologists and ophthalmologists believe that pupillary inequality due to uneven illumination is a physiological phenomenon. Pupillographic records do not agree with this view. Apparent inequality of the pupils results from an optical illusion on the part of the observer, whereby the pupil of the dimly lighted eye seems larger than that of the brightly illuminated one. Furthermore, References 1. References 1 through 3. 2. The darkness reflex should not be confused with the dark adaptation process. 3. References 4 and 5. 4. References 7 and 8. 5. Reference 10. 6. Lowenstein, O.: Der psychische Restitutionseffect: das Prinzip der psychisch bedingten Wiederherstellung der ermüdeten, der erschöpften und der erkrankten Funktion , Basel, Benno Schwabe & Co., 1937. 7. Lowenstein, O., and Friedman, E. D.: Pupillographic Studies: I. Present State of Pupillography; Its Method and Diagnostic Significance , Arch. Ophth. 27:969-993, 1942.Crossref 8. Lowenstein, O., and Loewenfeld, I. E.: Role of Sympathetic and Parasympathetic Systems in Reflex Dilatation of the Pupil: Pupillographic Studies , Arch. Neurol. & Psychiat. 64:313-340, 1950. 9. Lowenstein, O.: Clinical Pupillary Symptoms in Lesions of the Optic Nerve, Optic Chiasm, and Optic Tract , A. M. A. Arch. Ophth. 52:385-403, 1954. 10. Lowenstein, O.; Murphy, S. B., and Loewenfeld, I. E.: Functional Evaluation of the Pupillary Light Reflex Pathways: Experimental Pupillographic Studies in Cats , A. M. A. Arch. Ophth. 49:656-670, 1953. 11. Jones, I. S.: Anisocoria: Attempted Induction by Unilateral Illumination , Arch. Ophth. 42:249-253, 1949. 12. Behr, C.: Die Lehre von den Pupillenbewegungen , Berlin, Springer-Verlag, 1924. 13. Behr, C.: Der Augenbefund in seiner diagnostischen und differentialdiagnostischen Bedeutung bei Tabes dorsalis, Lues cerebrospinalis, multipler Sklerose , Berlin, S. Karger, 1936. 14. Marburg, O.: Multiple Sklerose, in Handbuch der Neurologie , edited by O. Bumke and O. Foerster, Berlin, Springer-Verlag, 1936, Vol. 13, Pt. 2, p. 655. 15. Lowenstein, O.: A Benign Postinfectious Disorder of the Anterior Midbrain: Alternating Contraction Anisocoria, Combined with General Fatigue and Peripheral Neuritis , A. M. A. Arch. Neurol. & Psychiat. , to be published. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Neurology & Psychiatry American Medical Association

ALTERNATING CONTRACTION ANISOCORIA: A Pupillary Syndrome of the Anterior Midbrain

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Publisher
American Medical Association
Copyright
Copyright © 1954 American Medical Association. All Rights Reserved.
ISSN
0096-6886
DOI
10.1001/archneurpsyc.1954.02330060078010
Publisher site
See Article on Publisher Site

Abstract

Abstract AMONG THE clinical cases examined in this laboratory a relatively large group showed a pupillary syndrome which I have named alternating contraction anisocoria. I have used the term contraction anisocoria in order to describe the appearance of inequality of the pupils under the influence of a pupilloconstrictor stimulus, such as light, while the term alternating is used because there is a variation as to which pupil becomes smaller. In alternating contraction anisocoria the pupil of the stimulated eye always contracts more extensively than does the consensually reacting pupil of the opposite side. Many neurologists and ophthalmologists believe that pupillary inequality due to uneven illumination is a physiological phenomenon. Pupillographic records do not agree with this view. Apparent inequality of the pupils results from an optical illusion on the part of the observer, whereby the pupil of the dimly lighted eye seems larger than that of the brightly illuminated one. Furthermore, References 1. References 1 through 3. 2. The darkness reflex should not be confused with the dark adaptation process. 3. References 4 and 5. 4. References 7 and 8. 5. Reference 10. 6. Lowenstein, O.: Der psychische Restitutionseffect: das Prinzip der psychisch bedingten Wiederherstellung der ermüdeten, der erschöpften und der erkrankten Funktion , Basel, Benno Schwabe & Co., 1937. 7. Lowenstein, O., and Friedman, E. D.: Pupillographic Studies: I. Present State of Pupillography; Its Method and Diagnostic Significance , Arch. Ophth. 27:969-993, 1942.Crossref 8. Lowenstein, O., and Loewenfeld, I. E.: Role of Sympathetic and Parasympathetic Systems in Reflex Dilatation of the Pupil: Pupillographic Studies , Arch. Neurol. & Psychiat. 64:313-340, 1950. 9. Lowenstein, O.: Clinical Pupillary Symptoms in Lesions of the Optic Nerve, Optic Chiasm, and Optic Tract , A. M. A. Arch. Ophth. 52:385-403, 1954. 10. Lowenstein, O.; Murphy, S. B., and Loewenfeld, I. E.: Functional Evaluation of the Pupillary Light Reflex Pathways: Experimental Pupillographic Studies in Cats , A. M. A. Arch. Ophth. 49:656-670, 1953. 11. Jones, I. S.: Anisocoria: Attempted Induction by Unilateral Illumination , Arch. Ophth. 42:249-253, 1949. 12. Behr, C.: Die Lehre von den Pupillenbewegungen , Berlin, Springer-Verlag, 1924. 13. Behr, C.: Der Augenbefund in seiner diagnostischen und differentialdiagnostischen Bedeutung bei Tabes dorsalis, Lues cerebrospinalis, multipler Sklerose , Berlin, S. Karger, 1936. 14. Marburg, O.: Multiple Sklerose, in Handbuch der Neurologie , edited by O. Bumke and O. Foerster, Berlin, Springer-Verlag, 1936, Vol. 13, Pt. 2, p. 655. 15. Lowenstein, O.: A Benign Postinfectious Disorder of the Anterior Midbrain: Alternating Contraction Anisocoria, Combined with General Fatigue and Peripheral Neuritis , A. M. A. Arch. Neurol. & Psychiat. , to be published.

Journal

A.M.A. Archives of Neurology & PsychiatryAmerican Medical Association

Published: Dec 1, 1954

References